Meeting Brainstorm

Meeting #2: Appendix

During the meeting, the members were asked to provide comments, corrections and/or suggestions in an effort to create actionable recommendations for the following agenda items: Subgroup Findings and Discussion, Guidelines for Providers and the State, Housing Determinants, and Capturing Savings Across Public Spending. The results from the brainstorming session are listed below, in no particular order.

Subgroup Findings and Discussion

  • Building Assets
  • Mini-grants/funds to support work/school/transportation
  • Evidence-based assessments
    • Washington State Institute of Public Policy
    • University of Wisconsin
  • Economic Stability outcome for people who are not able to work
  • Navigations of community resources to reach people BEFORE acute
  • Peer support (Griswold)
  • Food Insecurity
    • How to address barriers to getting fresh food on tables and which is easy to prepare - connect to DOH Nutrition services
    • Social Adult Day Food opportunities
      • Now only MLTC but could be used for people in mainstream managed care
      • Multi-level op certificate
  • Lack of Transportation
  • Rural Health Network - Mobility Management Program

Guidelines for Providers and the State

  • Require VBP networks to measure at least one SD
  • Bonus to Level One providers if they address at least one SD
  • "Model for Improvement"
  • Standards for infrastructure collaboration w/ benchmarks (network requirements for other essential sectors)
  • Start with an investment standard such as requiring investment of a percentage of savings
  • Ease of use is critical
  • Standardized tool with catalogue of community resources
  • Require action orientation. Example: homeless (social) admission for lack of quick alternative
  • Need to address isolation - especially for homeless person who is housed
  • Encourage incentivizing incremental changes in patient behaviors
  • Look at HARP assessment tool - includes measures of SD
  • Look at 1915i HCBS
  • Use NYS DOH Prevention Agenda
  • Identify division of labor that flows from uniform assessment
  • Raises issue of sharing data with community based provider
  • Change the measures that insurance companies use
  • Require participation in HIIO
  • Require use of risk/risk strategy assessment
  • Use social determinants for risk adjustment

Housing Determinants

  • Repurposing health facilities to meet housing needs
  • Telehealth
  • Congregate housing
  • Housing for elderly and others at risk. Getting multiple housing agencies/funders (municipal and state) - align with VBP and DSRIP
  • Uniform data collection
  • Metric - assessing stability of housing
  • Savings for capital or revolving, loan fund
  • Advocacy re: CMS Medicaid Regs; re: bricks and mortar and room and board
  • Housing as part of standard data set - status for PPSs, etc.
Capture Savings Across Public Spending
  • Corrections and behavioral health
  • Alternatives to incarceration for public intoxication
  • Care for inmates with chronic conditions eligible for parole
  • Warm hand-offs for re-entry
  • Penalize plans for high incarceration
  • Maintaining relationships during institutionalization
  • Jails contract for VBP provider services
  • Foster Care
  • Shelters
  • Look at intersect between various sectors´ long and short term outcomes
  • Homemaker program that averts foster-care
  • Linking savings to welfare savings
  • Coordinating care for children within foster care systems